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Comparison of oncological outcomes between retropubic radical prostatectomy and robot-assisted radical prostatectomy: an analysis stratified by surgical experience

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Abstract

Objectives

To compare oncological outcomes of a consecutive retropubic radical prostatectomy (RRP) and robot-assisted radical prostatectomy (RARP) series performed by a single surgeon who had performed >750 prior RRPs and was starting to perform RARPs.

Materials and methods

Prospectively collected longitudinal data of 277 RRP and 730 RARP cases over a 5-year period were retrospectively analyzed. The RARP series were divided into 3 subgroups (1st, <250 cases; 2nd, 250–500; and 3rd, >500) according to the surgical period. The positive surgical margin (PSM) and biochemical recurrence-free survival (BCRFS) rates were compared at each pathological stage.

Results

The pT2 PSM rates showed no significant difference between the RRP (7.8 %) and RARP series (1st, 9.5 %; 2nd, 14.1 %; and 3rd, 9.8 %) throughout the study period (P = 0.689, 0.079, and 0.688, respectively). Although the pT3 PSM rates of the 1st (50.6 %) and 2nd RARP series (50.0 %) were higher than that of the RRP series (36.0 %; P = 0.044 and P = 0.069, respectively), the 3rd RARP series had a comparable pT3 PSM rate (32.4 %, P = 0.641). The 3-year BCRFS rates of the RRP and RARP series were similar at each pathological stage (pT2, 92.1 vs. 96.8 %, P = 0.517; pT3, 60.0 vs. 67.3 %, P = 0.265, respectively).

Conclusions

The pT2 PSM and short-term BCRFS rates were similar between RRP and RARP, and RARP showed comparable pT3 PSM rate with RRP after >500 cases of surgical experience. Our data suggest that an experienced robotic surgeon at a high-volume center may achieve comparable oncological outcomes with open prostatectomy even in locally advanced disease.

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Author information

Authors and Affiliations

  1. Department of Urology, Eulji University Hospital, Eulji University, Daejeon, Korea

    Jinsung Park & Dae-Seon Yoo

  2. Department of Urology, Asan Medical Centre, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

    Cheryn Song, Sahyun Park & Hanjong Ahn

  3. Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea

    Sejun Park

  4. Department of Urology, Haeundae Paik Hospital, Inje University, Busan, Korea

    Seong Cheol Kim

  5. Department of Pathology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea

    Yongmee Cho

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  1. Jinsung Park
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Correspondence to Hanjong Ahn.

Additional information

Jinsung Park and Dae-Seon Yoo have contributed equally to this study.

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Park, J., Yoo, DS., Song, C. et al. Comparison of oncological outcomes between retropubic radical prostatectomy and robot-assisted radical prostatectomy: an analysis stratified by surgical experience. World J Urol 32, 193–199 (2014). https://doi.org/10.1007/s00345-013-1168-2

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  • DOI: https://doi.org/10.1007/s00345-013-1168-2

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